The following discussion from another group on the issue of back problems may
also be of interest here.

Mel Siff
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SQUATTING & BACK PROBLEMS

Todd Gastaldo wrote:

<<As much as I'd like to agree with Mr Asselbergs, his ability to comfortably
squat in adulthood may not be a consequence of his childhood squatting while
playing.

Stated another way, as with Mr. Asselbergs' daughter, ALL human children
(unless they are disabled) start flat-footed squatting all by themselves; BUT
even when they are forced to sit in chairs for prolonged periods, SOME retain
the flexibility necessary for comfortable squatting. Mr. Asselbergs may be
one of these fortunate few.

That said, I hasten to add that MOST Westerners wind up in adulthood having
been robbed of this fundamental human rest (and play) posture. As elderly
Western chairdwellers bill Medicare for "ejection" chairs to help them stand
up from their chairs, most elderly persons on the planet are able to stand
from a full squat without assistance... Medicaid pays billions per MONTH to
warehouse elderly Westerners - in part because of immobility that could be
easily prevented... Those who read me know that I call this The Great Squat
Robbery.

See:
 
Pt 1: Chiro prevention/CBP not onboard...
http://www.deja.com/=dnc/getdoc.xp?AN=450898123

Pt 2: THE GREAT SQUAT ROBBERY
http://www.deja.com/=dnc/getdoc.xp?AN=450898128>>

---------------------------------‘

Mel Siff:

***I read these two most interesting articles and can appreciate some merits
in all of the arguments, but in much of the deductive reasoning involved ,
there appears to be an allness approach - solution A is right; solution B is
wrong. Maybe there are merits in certain aspects of all the different
viewpoints.

INTRODUCTORY REMARKS

These articles suggest an hypothesis that all chair sitting is harmful and
the avoidance of the full squatting position sets up a chain of events which
is responsible for a great deal of back dysfunction.

Just as we cannot attribute all heart disease to altered cholesterol levels
or any single cause, we cannot fairly attribute all back pain and dysfunction
to one single or major cause. While I agree that prolonged periods of poorly
postured chair sitting (even in so-called ergonomically safe executive
chairs) and minimal use of full range squatting (or any other movements) may
be relevant factors in the evolution of certain back problems, there are also
other factors which may be equally important.

LOGICAL DEDUCTIONS?

It is well known that sitting in one unchanging position can cause or
exacerbate certain back and other problems, as is evident from the pressure
sores and back pain experienced by immobilised patients and spinal patients.
However, we are not justified in blaming these problems on the sitting
posture or the use of chairs in the 'normal' population.

What we can deduce from such situations is that back discomfort and
subsequent problems may well have a lot to do with the prolonged assumption
of a single, unvarying posture, which, inter alia, compromises blood flow,
imposes high levels of stress on the same structures for long periods and
sometimes imposes unmitigated stress on various nerves.

If one studies speeded-up time lapse photographs of people sitting, standing
and sleeping, it is amusing and enlightening to observe that the unparalysed
body is in a regular state of carrying out weird and wonderful 'dances' and
contortions which ostensibly take place to minimise the problems alluded to
above. It would appear that the nervous system contains a program which
automatically tries to minimise the risks associated with prolonged
maintenance of identical postures.

IDEAL POSTURE?

In other words, there is no such thing as an ideal posture. Although there
is a mechanical model of the body which suggests a most thermodynamically
efficient posture which minimises energy expenditure and distributes loads so
as to minimise stress on endangered regions, there are ongoing deviations
from ideal positions or states of theoretical homeostasis which optimise
efficiency and safety.

The body 'hunts around' positions of stasis (in a type of 'chaos', a field
which recently has attracted a great deal of attention among physicists,
engineers and physiologists), but never is in a state of perfect balance,
because (according to the laws of thermodynamics), such states of perfect
equilibrium or rhythm contain minimal information and do nothing to provide
useful feedback and control. Some studies even show that tendencies to lose
such deviations and attain greater rhythmicity (as in control of the cardiac
rhythm) may even be percursors of impending failure.

Thus, if one is to prescribe the best way of sitting, then we would say that
there is no single best way - the best way is to move regularly and avoid
maintenance of the same posture for prolonged periods. It is somewhat
simplistic to claim that back and knee problems are rare in aboriginal or
Eastern cultures just because their full squatting seating, cross-legged
sitting or kneeling positions prevent back or knee problems. If one spends
time in those cultures, you will notice that, even though seats are nowhere
in evidence, the people do not sit in exactly the same posture all the time -
they often vary their positions and are much more physically active than
their Western counterparts, who certainly appear to have become "homo sedens"
(sitting human).

ERGONOMIC SCIENCE?

Maybe we also need to comment on the fact that many primitive populations do
not sleep on cushy posture hugging beds, but on reed mats, hammocks or on
blankets laid on the ground. Surely something like 8 hours a day of back
positioning during sleep certainly needs to be taken into consideration in
analysing the aetiology of back problems Possibly we need to take a good,
hard look at the fundamental tenets of modern ergonomics which so far appears
to have had no noticeable impact on reducing the incidence of back problems
in the West.

It is actually a bit of a joke or swindle that some scientists proclaim that
an 'ergonomically correct' chair solves back problems. If they notice how
rarely a person sits in the exact same ergonomically ‘correct’ position on
one of these costly chairs, they would be a great deal more cautious in
penning this hypothesis. No matter what chair is used, a person will always
be shifting. It is the constant injunctions of parents, teachers and
military drill sergeants to "sit still", "stand still", "sit straight" and so
forth which often instill beliefs that it is wrong to fidget sometimes.
Fidgetting or postural shifting isnot always a sign of lack of control, but
it may be a natural process intended to ensure physical well-being.

Even then, it is not the mere act of sitting which is to blame; it is the
manner in which it is done. First of all, ergonomists have proliferated one
major error in seat design - they have perpetuated the use of a back rest, so
that the automatic tendency after a few minutes is for the average person to
lean back and allow the lumbar spine to flop into that very undesirable state
of loaded flexion.

SITTING OR MORE?

What is common to all the different Eastern and primitive methods of sitting,
whether it be in a lotus pose, Buddhist kneeling or full squatting, is that a
person cannot lean lazily against something. So, when the Westerner fatigues
during upright sitting, he simply leans back and slides further and further
down into a state of increasing lumbar flexion, whereas his 'less civilised'
colleagues change the positions of several other limbs.

So, it seems as if it is the manner of sitting and the almost universal use
of chair backs on Western seats have a lot more to do with back problems than
the mere act of chair sitting.

Let us take this issue a bit further. What effect does the chair height have
on back position? Can we fairly compare the effects of sitting on low chairs
with those of bar stools, even though the degree of spinal flexion tends to
be less on very, backless high chairs? What if we go to the other extreme of
using another Eastern and primitive design of very low chairs (yes, they
often also DO use chairs - I lived in Africa and among Eastern populations
for most of my life!) which allow the user to sit in an a very low position
with very flexed knees? Should we condemn this use of all types of chair?

PROBLEMS & INCREASED STRESS?

Another more intriguing issue is the fact that lumbar stress in the seated
position has been shown by Nachemson to be considerably greater than
equivalent activities in the standing position, yet many folk complain that
long periods of standing exacerbate back pain far more than the similar
periods of sitting. If back pain or dysfunction is associated with greater
levels of vertebral stress, then why does this happen? Similarly hospital
patients lying for prolonged periods in bed often complain of severe back
pain, even though Nachemson’s research shows that disc pressures are least of
all in lying poses. Obviously we are going to suggest that it is not only
disc stress, condition or thickness which may be implicated in the genesis of
back dysfunction and pain.

Finally, many of my Third World cousins used to complain about low back pain
if they squatted for long periods in very low positions which allowed for the
"tail to tuck under" the body – in other words, when forced nutation allowed
the pelvis to tilt posteriorly for prolonged periods and stressing ligaments
and connective tissue (and we know that these do contain proprioceptors and
nociceptors). So, even when the presumably safer position of full squatting
is used, back pain is quite commonly reported.

In short, we cannot logically conclude that many back problems are alone due
to modern seating or lack of squatting. It is apparent that the technique
or manner of executing any posture or exercise may be more to blame than the
activity concerned, where ‘manner’ includes issues such as technical skill,
patterns of movement, duration of loading, and the overtraining (overload and
overuse) syndrome.

Dr Mel C Siff
Denver, USA
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